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In their editorial on medicine and the Holocaust, Lerner and Rothman [1] wonder whether an ethic of “do no harm” can be reconciled with physician-assisted suicide or aid-in-dying [2, 3]. I would suggest that the word “harm” can be viewed differently depending on one's perception of the experience.

In December 1973, the House of Delegates of the American Medical Association adopted a resolution condemning mercy killing but condoning passive euthanasia. Rachels [4] took issue with this doctrine. When a patient is dying a slow and painful death, a lethal injection could be quick and painless, that is, more merciful. Passive euthanasia could be interpreted as a decision to prolong agony. Rachels concludes that “so, whereas doctors may have to discriminate between active and passive euthanasia to satisfy the law, they should not do any more than that. In particular, they should not give the distinction any added authority and weight by writing it into official statements of medical ethics.”